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A Comparative Study of Chronic Subdural Hematoma in Patients With and Without Head Trauma: A Retrospective Cross
Yunwei Ou1,2,3, Xiaofan Yu1, Xiaojuan Liu1
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
This study found differences in clinical characteristics between chronic subdural hematoma (CSDH) patients with and without head trauma history. However, optimal surgical strategies like exhaustive drainage lead to similar positive outcomes for both groups.
Area of Science:
- Neurosurgery
- Neurology
- Trauma Surgery
Background:
- Clinical features of chronic subdural hematomas (CSDHs) in patients with and without a history of head trauma are not well-defined.
- Investigating these differences is crucial for understanding CSDH pathophysiology and tailoring treatment.
Purpose of the Study:
- To compare the clinical characteristics of CSDH patients with and without a history of head trauma.
- To identify potential differences in demographics, comorbidities, and surgical outcomes between these two groups.
Main Methods:
- Retrospective collection of clinical data from 1,307 CSDH patients undergoing burr-hole craniostomies.
- Patients were divided into trauma and no-trauma groups.
- Statistical analyses (chi-square, t-tests, multiple linear regression) were used to compare groups and analyze outcomes.
Main Results:
- Patients with head trauma were older on average than those without (64.0 vs. 61.5 years).
- The no-trauma group had a higher prevalence of hypertension (40.2% vs. 32.9%).
- While dizziness was more common in the trauma group (29.2% vs. 23.1%), hematoma cavity reduction was greater post-surgery in this group (p=0.002), and hospital stay was longer (7.9 vs. 7.3 days).
Conclusions:
- Notable differences exist in the clinical and pathogenic characteristics of CSDH patients based on head trauma history.
- Despite these differences, employing optimal surgical techniques, such as exhaustive drainage, can achieve comparable treatment outcomes in both groups.
- This suggests that treatment strategy is a key factor in managing CSDH regardless of trauma history.
Abstract:
Background: The clinical features of chronic subdural hematomas (CSDHs) in patients with and without a history of head trauma have remained unclear. Here, we investigated differences in clinical characteristics in CSDH patients with and without head trauma. Methods: We retrospectively collected clinical characteristics of CSDH patients who had undergone exhaustive drainage strategies via burr-hole craniostomies from August 2011 to May 2019. We divided patients into a trauma group (i.e., head trauma) and a no-trauma group. Chi-square tests or t-tests were used to analyze differences in clinical characteristics between the two groups. Multiple linear regression analysis was performed to analyze the relationships between the clinical characteristics and either reduction of the hematoma cavity or length of the hospital stay in CSDH patients with trauma. Results: We collected data from 1,307 CSDH patients, among whom 805 patients had a history of head trauma whereas 502 patients did not. The mean age of patients with head trauma was 64.0 ± 16.1 years, while that of patients without head trauma was significantly younger at 61.5 ± 17.9 years (p = 0.010). Furthermore, more patients in the no-trauma group had a history of hypertension compared to those in the trauma group (40.2 vs. 32.9%, p = 0.007). Dizziness occurred in 29.2% of patients with trauma and in 23.1% of patients without trauma (p = 0.016). A greater number of patients with trauma showed a reduction of hematoma cavity after surgery compared to that of patients without trauma (p = 0.002). The length of hospital stay in patients with trauma was 7.9 ± 4.5 days, which was longer than that of patients without trauma (7.3 ± 3.7 days, p = 0.016). In contrast, there were no significant different differences between the two groups in terms of the densities of hematomas on computed-tomography scans, complications, mortality rates, recurrence rates, or outcomes. Conclusion: Our findings indicate that there were some noteworthy differences in the clinical and pathogenic characteristics of CSDH patients with and without head trauma. However, our findings also indicate that if an optimal treatment method is employed, such as our exhaustive drainage strategy, similar treatment outcomes can be achieved between these groups.
